Objective To summarize nursing management and clinical care experience for six patients with systemic lupus erythematosus (SLE) who received chimeric antigen receptor T cell (CAR-T) immunotherapy.Methods A comprehensive, standardized nursing pathway was implemented for the six SLE patients throughout the entire treatment process. Pre-infusion measures included systematic risk assessment and management, optimization of comorbid conditions, infection screening, and completion of cell collection and lymphodepletion preparation. During infusion, strict aseptic technique was maintained, infusion rate of the cellular product was controlled, and vital signs and adverse events were monitored in real time. Post-infusion care focused on surveillance and management of cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and cytopenias, while psychological support, nutritional therapy, and patient education were provided continuously across the treatment course. Result All six patients successfully received CD19-targeted CAR-T cell infusion and achieved the intended therapeutic response. Five patients developed grade I CRS, of whom four presented primarily with fever. All five experienced scattered cutaneous rashes at multiple body sites; four reported myalgia or limb fatigue. All six patients developed varying degrees of leukopenia, with two patients also exhibiting concurrent anemia and thrombocytopenia. No cases of ICANS were observed.Conclusion CAR-T immunotherapy for SLE showed favorable therapeutic effects in this small series, but was frequently accompanied by complications. Timely, comprehensive nursing interventions covering the entire treatment cycle are essential to ensure safe and smooth delivery of CAR-T therapy.